Provider Demographics
NPI:1851871891
Name:REYNA, JOSE CRUZ JR (MS)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:CRUZ
Last Name:REYNA
Suffix:JR
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:513 E LORENZANA ST
Mailing Address - Street 2:
Mailing Address - City:MERCEDES
Mailing Address - State:TX
Mailing Address - Zip Code:78570-2132
Mailing Address - Country:US
Mailing Address - Phone:956-373-5340
Mailing Address - Fax:
Practice Address - Street 1:801 HIDALGO ST
Practice Address - Street 2:
Practice Address - City:MERCEDES
Practice Address - State:TX
Practice Address - Zip Code:78570-2632
Practice Address - Country:US
Practice Address - Phone:956-514-2000
Practice Address - Fax:956-514-2033
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-20
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123094235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX123094Medicaid
TX38499Medicaid